Provider Demographics
NPI:1881147080
Name:DUPONT, DANIELLE MARIE (BCBA)
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:MARIE
Last Name:DUPONT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E EVANS ST
Mailing Address - Street 2:APT C113
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2739
Mailing Address - Country:US
Mailing Address - Phone:860-748-1605
Mailing Address - Fax:
Practice Address - Street 1:11 GILCHREST ST
Practice Address - Street 2:APT. 3
Practice Address - City:THOMASTON
Practice Address - State:ME
Practice Address - Zip Code:04861-1634
Practice Address - Country:US
Practice Address - Phone:860-748-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst